摘要
目的:探讨静脉留置针行持续臂丛神经阻滞镇痛(CPNA)在上肢手术术后疼痛的临床疗效及经验总结。方法:将我院麻醉科2011年3-5月收治的38例行上肢手术且接受术后镇痛的患者随机分为CPNA组(持续臂丛神经阻滞镇痛)与PCSA组(皮下自控镇痛)。CPNA组采用静脉留置针于肌间沟穿刺,予以持续臂丛神经阻滞镇痛;PCSA组患者采用皮下注射舒芬太尼自控镇痛。手术结束后4、12、24、48h行静态和动态疼痛视觉模拟评分(VASr、VASm),同时观察不良反应。结果:术后4个时间点CPNA组VAS评分明显低于PCSA组,术后不良反应发生率低于PCSA组,差异均有统计学意义(P<0.05)。结论:上肢手术后持续臂丛神经阻滞镇痛(CPNA)效果满意,不良反应发生率低,适于临床应用。
Objective:To study the clinical effects and the skills summary of continuous perineural block analgesia(CPNA) through a perivasculer catheter after the upper limb surgery analgesia. Methods: Randomly divide the 38 patients into group CPNA and group PCSA(patient-controlled subcutaneous analgesia), who had received upper limb surgeries and the patient controlled analgesia from March 2011 to May in our anesthesia department. Patients in group CPNA were placed vein-indwelling needles at interscalene sulcus and received PCA at postoperatiorL Patients in group PCSA were received patient-controlled subcutaneous analgesia with sufentanil. Visual analogue scales rest (VASt) ,visual ana-logue scales move(VASm) and the adverse effects were observed at 4,12,24,48 hours after surgery. Results: VAS of group CPNA is far lower than group PCSA at the 4 time points after surgery, and the occurring frequency of adverse effects is lower as well. All differences have statistical significance (P〈0.05). Conclusion: CPNA after upper limb surgery is quite satisfactory with lower occurring frequency of untoward effect. So,it is adaptable to clinical application.
出处
《医学理论与实践》
2012年第14期1690-1691,1695,共3页
The Journal of Medical Theory and Practice
关键词
上肢手术
持续臂丛神经阻滞
术后镇痛
Upper limb operation,Continuous brachial plexus block, Patient-controlled postoperation analgesia